Carr v. Department of Health & Human Services, 218 N.C. App. 151

On May 5, 2008, Carr, a licensed practical nurse, was hit from behind by a patient and sustain ed left-hand injury.
MRI later revealed a left C6-7 subligamentous disc herniation with cord impingement and stenosis.
Carr underwent C6-7 anterior cervical discectomy and fusion on July 25, 2008 and was released to return to work with a 10-pound lifting restriction.
Defendant accepted the left-hand injury as compensable via Form 60 but denied other injuries; Form 61 denied neck/back injuries.
Full Commission found the neck condition was causally related to the May 5, 2008 incident and that medical treatment was necessary, and that Carr was disabled from May 5, 2008 onward.
The case was remanded to the Commission for further findings on whether Carr is totally disabled under Russell v. Lowes Prod. Distrib. (second/third prongs).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the neck injury is causally related to the May 5, 2008 left-hand injury	Carr argues the neck condition was caused or aggravated by the May 5 incident.	Caswell contends there is insufficient medical causation linking the neck issue to the hand injury.	Yes; expert medical evidence supports causation.
Whether Carr is entitled to disability benefits based on inability to earn wages	Carr is disabled and unable to earn wages due to the neck injury.	Defendant argues lack of sufficient findings under the Russell framework for disability.	Remanded for additional Russell-based findings (second/third prongs).

Parsons v. Pantry, Inc., 126 N.C.App. 540, 485 S.E.2d 867 (1997) (establishes Parsons presumption of relatedness after initial injury)
Perez v. American Airlines/AMR Corp., 174 N.C.App. 128, 620 S.E.2d 288 (2005) (recognizes Parsons presumption where Form 60 accepted a compensable injury)
Young v. Hickory Bus. Furniture, 353 N.C. 227, 538 S.E.2d 912 (2000) (causation requires more than speculative testimony; handler of medical causation must be more than speculative)
Richardson v. Maxim Healthcare/ Allegis Grp., 362 N.C. 657, 669 S.E.2d 582 (2008) (review limited to whether competent evidence supports findings)
Anderson v. Lincoln Constr. Co., 265 N.C. 431, 144 S.E.2d 272 (1965) (credibility and weight of witnesses are for the Commission)
Click v. Pilot Freight Carriers, Inc., 300 N.C. 164, 265 S.E.2d 389 (1980) (causation in complex medical questions requires expert testimony)
Hilliard v. Apex Cabinet Co., 305 N.C. 593, 290 S.E.2d 682 (1982) (employment disability standard requires medical evidence of incapacity for any work)
Russell v. Lowes Prod. Distrib., 108 N.C.App. 762, 425 S.E.2d 454 (1993) (disability proof can rely on second/third Russell prongs (ability to work and reasonable efforts))